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Reading: Persons Living with Complex Needs’ Experience with Integrated Patient Care in Ontario, Canada

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Conference Abstracts

Persons Living with Complex Needs’ Experience with Integrated Patient Care in Ontario, Canada

Authors:

Reham Abdelhalim ,

IHPME, CA
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Agnes Grudniewicz,

CA
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Kerry Kuluski,

CA
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Walter Wodchis

CA
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Abstract

Introduction

Many healthcare systems are integrating care for persons living with complex health and social care needs. Successful Integrated Patient Care (IPC) is expected to improve the quality of care, decrease unnecessary healthcare utilization, and enhance patient experience. Patients/persons are the only ones to experience all the care they receive across providers and provider organizations and over time. They are uniquely qualified to say whether their care is integrated in ways that meet their needs and preferences. However, care experience is still one of the least reported outcomes in integrated care evaluation literature.

Aims Objectives Theory or Methods

We assessed the patient experience with a wide-scale IPC initiative in Ontario, Canada. A cross-sectional survey was mailed in July 2019 to 683 patients who were enrolled in the IPC initiative in one local health authority for at least six months. The survey covered constructs of communication, patient empowerment, information flow, relationship with providers, shared decision-making, continuity of care, access, and knowing what to expect. Exploratory factor analysis (EFA) was conducted to reveal the latent structure of the survey. The impact of awareness of having a care plan and satisfaction with the care coordinator on the survey results were examined.

Highlights or Results or Key Findings

The response rate was 26.71%; The constructs that were associated with positive experience were patient empowerment, knowing what to expect, and shared decision making. Communication, information flow, care continuity, and access were not perceived to be enhanced by the IPC approach. Although all respondents had a care plan developed, only 66.6 % of respondents were aware of having a care plan, and less than half reported having a copy of the care plan. The EFA revealed a three-factor solution. The three factors were care planning, person-centredness and Perceived support for coordination and self-management support. Awareness of having a care plan and satisfaction with the care coordinator were both significantly associated with better experience per survey item on most of the survey questions as well as higher average summary scores for the three survey factors. However, regression analysis showed that satisfaction with the care coordinator would better predict the factor scores.

Conclusions

The results indicated that the intended components of the IPC initiative (personalized care plan and care coordinator) were strongly positively related to better patient experience. However, issues with implementing these two components affected the care experience negatively.  This was reflected in the low scores on communication, coordination, and information

Implications for applicability/transferability sustainability and limitations

Our results can inform researchers on how to better assess the patient experience with IPC initiatives. Additionally, it can guide policy makers, funders, and implementers on what is most important to persons living with complex needs, which can facilitate designing interventions that better align with their needs and expectations.

How to Cite: Abdelhalim R, Grudniewicz A, Kuluski K, Wodchis W. Persons Living with Complex Needs’ Experience with Integrated Patient Care in Ontario, Canada. International Journal of Integrated Care. 2022;22(S2):181. DOI: http://doi.org/10.5334/ijic.ICIC21266
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Published on 16 May 2022.

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